2 Minute Medicine ® - Sleep Medicine

1. In healthcare workers experiencing shift work disorder, behavioral therapy was effective in improving insomnia severity after 2 weeks. 2. Patients receiving behavioral therapy for treatment had greater improvements in daytime sleep than the control group. Evidence Rating Level: 1 (Excellent) A common consequence of shift work is insomnia and sleepiness which is known as shift work disorder (SWD). Most treatments for SWD are focused on pharmacotherapy such as hypnotics to extend daytime sleep and stimulants to alleviate sleepiness...

1. In patients with acute insomnia, an online behavioral self-help intervention was effective in reducing insomnia severity within one week. 2. Patients with acute insomnia provided with a two-page PDF self-help leaflet reported reduced insomnia severity index (ISI) scores from baseline at one-week, one-month, and three-month follow-up periods. Evidence Rating Level: 1 (Excellent) Insomnia is a highly prevalent sleep disorder associated with negative physical and psychological health outcomes. Pharmacological treatments for insomnia such as benzodiazepines are associated with negative side effects...

1. In children with obstructive sleep apnea syndrome, atypical deglutition was associated with more severe apnea. 2. Atypical deglutition was more strongly associated with increased pharyngeal collapsibility and altered facial measurements in children. Evidence Rating Level: 2 (Good) Tongue thrusting is a normal phenomenon in neonates, but lack of cessation by age 6 results in atypical deglutition. Atypical deglutition may be linked to pediatric obstructive sleep apnea (OSAS). As a result, correction of atypical deglutition through myofunctional therapy could improve OSAS symptoms...

1. In people with pre-existing medical conditions, there is a higher risk of long COVID in short sleepers compared with average-length sleepers. 2. Increasing habitual sleep may be a potential modifiable risk factor for long COVID in people with pre-existing conditions. Evidence Rating Level: 1 (Excellent) The risk of long COVID-19—defined as persisting symptoms and long-term sequelae after a COVID-19 infection—has been linked to pre-existing conditions such as chronic obstructive pulmonary disease, anxiety, depression, heart disease, hypertension, and diabetes...

1. A machine learning model was developed for estimating vigilance impairment for high-risk shift work occupations using only data from a single prior sleep period. 2. The model was found to be comparable to current fatigue prediction models that relied upon self-reported data and multi-night measurements. Evidence Rating Level: 1 (Excellent) The ability to predict vigilance impairment in shift workers is critical to reducing workplace errors and accidents. Current methods for evaluating vigilance involve infeasible self-reported data and laborious multi-night measurements...

1. In patients with mild cognitive impairment, empowerment-based cognitive behavioural therapy was shown to improve sleep and cognition after 6 months. 2. Patients receiving cognitive behavioural therapy had a greater reduction in insomnia and greater improvement in global cognition when compared to patients receiving standard care. Evidence Rating Level: 1 (Excellent) Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia. Sleep disturbance is an important risk factor for progression to further cognitive impairment...

1. In this systematic review, Parkinson’s disease patients with freezing of gait (FOG) experienced overall worse sleep quality, increased daytime sleepiness, and more disruptive sleep disturbances than those without FOG. 2. Furthermore, Parkinson’s disease patients with FOG had a higher likelihood and greater severity of rapid eye movement behavior disorder than Parkinson’s disease patients without FOG. Evidence Rating Level: 1 (Excellent) Patients with Parkinson’s disease (PD) experience several motor and cognitive effects...

1. In this cross-sectional study, there was a significant association between insufficient sleep duration and the presence of moderate or severe periodontitis and tooth loss. 2. Furthermore, both insufficient and excessive sleep were associated with increasing periodontitis. Evidence Rating Level: 3 (Average) Periodontitis is a highly prevalent condition and is the main cause of tooth loss. Periodontitis and tooth loss can precipitate other problems, such as sleep disruption, low mood, and cognitive impairments...

1. In this cross-sectional study, household food insecurity and daily servings of sugar-sweetened beverages were associated with sleeping less than the recommended sleep duration in children 4-60 months old who were supported by the Special Supplemental Nutrition Program for Women, Infants, and Children. 2. Furthermore, each additional serving of sugar-sweetened beverages was associated with increased odds of sleeping less than the daily recommended sleep duration. Evidence Rating Level: 3 (Average) Child development is dependent on several factors, including optimal sleep duration...

1. In this cross-sectional study, participants who engaged in weekend catch-up sleep had a lower prevalence of cardiovascular disease than those who did not. 2. However, this was most prominent in participants with an average weekday sleep duration of <6 hours and a weekend catch-up sleep duration of >2 hours. Evidence Rating Level: 3 (Average) Limited sleep duration is a risk factor for several medical conditions, including cardiovascular disease. Although over a third of Americans get less than the recommended minimum sleep duration, this is often supplemented by a longer sleep duration on weekends, known as weekend catch-up sleep...

1. In this cross-sectional study, the association between sleep time and hepatic steatosis index (HSI) was dependent on body mass index (BMI). 2. However, analyses showed that sleep time may explain 39% of the relationship between body fat distribution and HSI. Evidence Rating Level: 3 (Average) It is well known that sleep is a factor associated with adiposity in young people, as inadequate sleep time is associated with an increasing risk of developing overweight or obesity. Overweight and obesity pose health threats, not least of which is non-alcoholic fatty liver disease (NAFLD), which is a leading cause of liver disease in pediatric populations...

1. In this cross-sectional study, a higher internet gaming disorder (IGD) score was associated with increasing insomnia severity, paranoid ideation, and psychoticism. 2. However, insomnia severity fully mediated the association between IGDs and paranoid ideation, while cyberbullying partially mediated the association between IGDs and psychoticism. Evidence Rating Level: 3 (Average) Online gaming is a common form of recreation, and studies show that internet gaming disorders (IGDs) are highly prevalent in adolescents and young adults...

1. This randomized controlled trial found that children with obstructive sleep apnea syndrome (OSAS) had significantly higher nasal resistance than those without OSAS. 2. However, in participants who were effectively treated with intranasal corticosteroids and oral montelukast, there were improvements in nasal resistance, nasal minimal cross-sectional area, and nasal cavity volume. Evidence Rating Level: 1 (Excellent) Obstructive sleep apnea syndrome (OSAS) is a common condition in children that can have detrimental effects on overall health and quality of life...

1. This randomized controlled trial found that patients with more severe depressive symptoms exhibited more significant underestimation of total sleep time and discordance between diary-based and actigraphic sleep parameters. 2. However, those who received bright light therapy showed greater improvements in diary-based time to fall asleep and rise time than those in the control group. Evidence Rating Level: 1 (Excellent) Depression is a common mental health disorder often associated with sleep disturbances, and those with an eveningness chronotype are particularly susceptible to these effects...

1. Sleep restriction therapy was superior to sleep hygiene for the management of chronic insomnia. 2. There were no treatment-related adverse events. Evidence Rating Level: 1 (Excellent) Study Rundown : Insomnia is a chronic disorder affecting 10% of people worldwide. Although cognitive behavioural therapy (CBT) remains the primary treatment for insomnia, access to this is scarce. Instead, patients are often counselled on sleep hygiene and prescribed hypnotic medications in certain circumstances. This randomized controlled trial aimed to assess the clinical and cost-effectiveness of nurse-delivered sleep restriction therapy for the treatment of insomnia...

1. In this systematic review and meta-analysis, patients with obstructive sleep apnea (OSA) had lower 25-hydroxyvitamin D (25-OHD) levels and a higher prevalence of vitamin D deficiency than those without OSA. 2. However, continuous positive airway pressure (CPAP) treatment was not associated with significant changes in serum 25-OHD levels in patients with OSA. Evidence Rating Level: 1 (Excellent) Both obstructive sleep apnea (OSA) and vitamin D deficiency are associated with cardiovascular risks. Vitamin D deficiency is associated with several respiratory conditions, and the relationship between this deficiency and OSA is being recognized as increasingly important...

1. This retrospective cohort study found that poor sleep quality and increased light exposure at night were associated with more symptoms of stress and depression during the 3rd trimester of pregnancy. 2. However, poor sleep quality, but not light exposure, was associated with worsening anxiety and depression levels during the 2nd trimester. Evidence Rating Level: 2 (Good) Psychological wellbeing is essential during pregnancy for optimal birth outcomes. However, pregnant women are particularly susceptible to stress, anxiety, and depression, which can negatively impact pregnancy outcomes...

1. This systematic review found that all studies reported an association between physical activity and improved sleep quality and reduced severity of sleep disorders. 2. However, physical activity duration, time, and frequency were important. High-intensity physical activity for more than 90 minutes was associated with worse sleep quality. Evidence Rating Level: 1 (Excellent) Sleep disorders and disruptions in sleep quality are highly prevalent and can negatively impact quality of life. Physical activity is associated with increased melatonin production, reduced stress, and improved mood, all of which can assist with sleep...

1. In this cross-sectional study, there was a negative association between sleep duration and dental caries. 2. Furthermore, those who slept an average of ≥7 hours were less likely to have dental caries than those who slept <7 hours. Evidence Rating Level: 2 (Good) Dental caries are highly prevalent worldwide and can significantly impact overall health and quality of life in patients. A lack of sleep can be associated with inflammation, reduced immune function, and increased susceptibility to many conditions...

1. In this cross-sectional analysis, long sleep duration (≥9 hours) was significantly associated with carotid plaque presence and larger total plaque area. 2. However, short sleep duration and daytime sleepiness showed no association with carotid plaque burden. Evidence Rating Level: 2 (Good) Sleep is an essential part of cardiovascular health, as the American Heart Association outlines. Prior studies have indicated a relationship between sleep duration and stroke risk. However, the pathology behind this association has yet to be well studied...